Contraception consultation and assessment for women over 40

Access to contraception is a basic human right, and one that empowers women to support pregnancy planning. When assessing a woman over the age of 40 for contraception, concerns such as comorbidity, changes to menstrual pattern, irregular bleeding and the management of additional perimenopausal and menopausal symptoms are essential considerations. While many methods of contraception can be used in menopause, some may need to be changed to safer, alternative methods. Most women will require some form of contraception (often taken alongside hormone replacement therapy) until the age of 55 years. This article will focus on contraception consultation and assessment, prescribing considerations in relation to age and menopause, contraceptive formulations (hormonal methods and the copper IUD) and the potential health implications of using specific forms of contraception.